DOCTORS CRITICAL OF FREE HEROIN EXPERIMENT

VANCOUVER - A controversial program to give free heroin to
addicts in the Vancouver area is under fire from addiction experts.

Under the trial program, to be funded by the Canadian Institutes of
Health Research in Vancouver, Toronto and Montreal, 470 addicts would
be prescribed up to 1,000 milligrams of heroin and/or unlimited
methadone per day.

Two staff physicians at Toronto's Centre for Addiction and Mental
Health (NAOMI) have written scathing critiques of the North American
Opiate Medication Initiative to Diane Fafard, the institutes' ethics
policy advisor in Ottawa.

"The NAOMI trial has serious design flaws and major safety and ethical
problems," wrote doctors Meldon Kahan and Kay Shen in a letter dated
Dec. 21, 2004.

Among their criticisms: that the combination of large amounts of
heroin and methadone could put subjects at significant risk for
hypoxia, a potentially fatal lack of oxygen in the blood and/or
tissues; that some patients addicted to legal heroin-like drugs could
end up addicted to heroin; and that the eligibility criteria are too
broad, allowing addicts who only briefly tried methadone treatment
into the program.

"The trial should only recruit patients who continue to inject heroin
daily despite at least four months of methadone treatment, at a dose
of at least 100 mg for one month or more," the Toronto doctors wrote.

Vancouver NAOMI spokesman Jim Boothroyd said investigators "are aware
of the criticisms" and a process is in place to answer concerns
raised. Boothroyd said the first enrolments are scheduled for Jan. 17
in Vancouver, but final approval has not yet been granted.

The addicts will inject heroin two to three times per day for one
year, and will then be tapered off the drug. The trial, patterned
after a similar trial in Europe, is the first of its kind in North
America.